Provider Demographics
NPI:1558497859
Name:CENDESE, JAN WORSLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:WORSLEY
Last Name:CENDESE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 WASATCH BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-4709
Mailing Address - Country:US
Mailing Address - Phone:801-274-2300
Mailing Address - Fax:801-277-8800
Practice Address - Street 1:4505 WASATCH BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4709
Practice Address - Country:US
Practice Address - Phone:801-274-2300
Practice Address - Fax:801-277-8800
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13845035011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical